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ADVISORY 2003-18

SUBJECT: Approved Doctor List (ADL) and Preauthorized Services

Beginning September 1, 2003, only authorized doctors may provide and be reimbursed for health care services rendered to injured workers in the workers' compensation system. An "authorized" doctor is one who has applied for and been approved to be on the Approved Doctor List (ADL), or who has been granted an exception to the requirement to be on the ADL. The doctor must be authorized on the date the health care is actually provided. This includes health care that has been preauthorized or voluntarily precertified by agreement between the health care provider and the insurance carrier. A preauthorization approval received by a doctor who was on the ADL at the time of the request, remains valid and does not have to be resubmitted, but the health care must be provided by a doctor who is authorized on the date-of-service. If the doctor who obtained preauthorization is no longer authorized on the date the preauthorized or precertified service is to be delivered, the patient must be transferred to a doctor who is authorized to provide health care in the workers' compensation system.

Signed on this 28th day of August, 2003

Richard F. Reynolds, Executive Director

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